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Patient choice in elective care increased emergency readmissions

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1793 (Published 15 April 2019) Cite this as: BMJ 2019;365:l1793

Re: Patient choice in elective care increased emergency readmissions

To the responses by Dr Ford, a retired GP, and Mr Thomas, a working orthopaedic surgeon, may I add my h’penny’s worth? I have a retrospectoscope going back to1960 - a health service as originally modelled.

In those days, a widowed old lady, troubled by a degenerated hip, living, say, in John O’Groats, who had kin living in Norwich and in Exeter, could request her GP to refer her to the surgeon at the Norfolk and Norwich Hospital or to the Royal Devon and Exeter.
No catchment areas then.
She could be so referred. No nonsense of “money following the patient”.
That was the real patient centred service.

Now? You have a clutter of economists, millions of computers, billions of software.
Instead of a hospital secretary (plus assistant), a Hospital GROUP Secretary with a treasurer, a Regional Hospital Board with one secretary and a few clerks, in the Postgraduate Teaching Hospitals, a House Governor plus Assistant Governor and three clerks, now you have Strategic Authorities and numerous other boards and clinical commissioning groups, etc.

WE DO NOT HAVE ENOUGH MONEY TO TREAT THE PATIENTS, wail the Chief Executives.
Is it any wonder? Blame patient choice.

Competing interests: Patient

25 April 2019
JK Anand
Retired doctor
Free spirit
Peterborough